Colorectal cancer screening barriers and facilitators among Jordanians: A cross-sectional study

Khaled Jadallah; Moawiah Khatatbeh; Tagleb Mazahreh; Aroob Sweidan; Razan Ghareeb; Aya Tawalbeh; Ansam Masaadeh; Bara Alzubi; Yousef Khader

doi:10.1016/j.pmedr.2023.102149

Colorectal cancer screening barriers and facilitators among Jordanians: A cross-sectional study

Prev Med Rep. 2023 Feb 13:32:102149. doi: 10.1016/j.pmedr.2023.102149. eCollection 2023 Apr.

Authors

Khaled Jadallah¹, Moawiah Khatatbeh², Tagleb Mazahreh³, Aroob Sweidan⁴, Razan Ghareeb⁵, Aya Tawalbeh¹, Ansam Masaadeh¹, Bara Alzubi¹, Yousef Khader⁶

Affiliations

¹ Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
² Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan, and School of Health and Environmental Studies, Hamdan Bin Mohammed Smart University, Dubai, United Arab Emirates.
³ Department of Surgery, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
⁴ Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
⁵ Department of Internal Medicine, Jordan University Hospital, Faculty of Medicine, University of Jordan, Amman, Jordan.
⁶ Department of Community Medicine, Public Health, and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

Abstract

The factors affecting the adherence of Jordanians to colorectal cancer (CRC) screening remain underexplored. We examined the inhibitory and facilitating factors that influence the uptake of CRC screening among Jordanians. We conducted questionnaire interviews between April 2020 and June 2021 with 861 Jordanians aged 50-75. We analyzed the differences between proportions using the chi-square test. Binary logistic regression was conducted to determine factors associated with awareness of CRC and its screening. Of all participants, 41.7 % were aware of the necessity of screening for CRC, and 27.2 % were aware of at least one of the tests for CRC screening. However, only 17.2 % of participants underwent screening. In the multivariate analysis, participants with higher income (p-value < 0.001, odds ratio[OR] = 1.9, 95 % confidence interval [CI]: 1.4-2.7), higher level of education (p-value < 0.001, OR = 2.6, 95 % CI: 1.8-3.7), family history of colon cancer (p-value < 0.001, OR = 2.8, 95 % CI = 1.7-4.5), and those who had been screened for other cancers (p-value = 0.003, OR = 1.7, 95 % CI: 1.2-2.5) were more aware of the necessity of screening. Concerning barriers to screening, 'feeling well,' lack of physician endorsement, and difficult access to health care were the most commonly reported inhibitory factors (53.9 %, 52.3 %, and 31.9 %, respectively). The most commonly stated incentivizing factor was physician endorsement (82.3 %). Screening rates for CRC in eligible Jordanians remain low, albeit more than one-third of participants are aware of the necessity of screening. Enhanced awareness of barriers and incentivizing factors should help to prioritize national strategies to improve screening rates.

Keywords: Adherence; Attitudes; Barriers; CI, Confidence interval; CRC, Colorectal cancer; Colorectal cancer; EMR, Electronic medical records; Facilitators; GPs, General practitioners; Jordan; OR, Odds ratio; Perception; Screening; USPSTF, US preventive services task force.